Practice Management Alert

Find out why specialty matters in coder productivity numbers.

Figuring out how many coders your practice needs is an important and tricky aspect of managing a medical office, especially if you have multiple providers whose specialties vary.

Every coder’s knowledge base and experience level is unique, and deciding how to pace your hiring to your coding demands depends on several factors.

Think About the Job Components

Obviously, a coder needs to look at patients’ health records and translate aspects of their encounter into the respective diagnosis and/or procedure codes. But what does the coder have to do or use to get that information? For example, are all of your practice’s records accessible within a single computer system or otherwise integrated for easy access?

“Do the coders have to search for the op note in one system, the pathology in another, then enter the charges into a third? Expect that to take longer than one fully integrated system,” says Christine Speroni, CPC, CEMC, manager of revenue cycle at NHPP Gynecologic Oncology in Ronkonkoma, New York.

If providers are entering some coding information, coders can probably code an encounter more quickly than if they’re starting from scratch, transposing the provider’s notes for the appropriate CPT^® and ICD-10-CM codes.

Coding incorporates a lot of information — and many codes, including diagnosis codes, are updated annually. For coders to stay at the top of their game, they need the time and bandwidth to continue their education. But you may also want coders to take on other responsibilities, like educating providers or handling some billing obligations. Those coding-adjacent obligations affect productivity in terms of case volume, Speroni says.

Even though that time spent navigating computer systems isn’t exactly coding, it can take a lot of time and definitely affects each coder’s productivity.

Similarly, if the providers at your practice are involved in complex cases or certain specialties, coders may appear to be less productive — on paper.

Coding 20 chest X-rays might go a lot faster than coding 20 orthopedic surgeries, Speroni says.

The way you structure your coder assignments also affects their productivity. If you pair each coder with a particular provider, the volume of patients a provider sees in a day may mean vastly different caseloads for coders.

If one provider sees 20 patients in a day and another sees more than 60, it might make more sense to assign coders according to the volume, for example, rather than the provider.

Take Experience Into Account

Coding involves a lot of expertise, regardless of specialty, and a coder’s experience can really affect how many cases they can get through. A Certified Professional Coder Apprentice (CPC-A) may need more time on each case than a CPC with years of experience, Speroni notes. But an experienced CPC may also need extra time if they switch to a new specialty and have to become familiar with new categories for diagnosis and procedure codes.

Again, the specialty really matters here, too. A coder working for a practice that sees a wide range of complains may need more time to research the correct codes and guidelines for usage than a specialty practice that sees a lot of patients who are all coming in for similar issues. Being able to rattle off cardiology ICD-10-CM codes without needing to look at a book means getting through cases faster than looking up diagnosis codes for everything from foreign body removal to pneumonia to chickenpox.

Don’t Forget to Define Expectations

Generally, full-time work is considered to be 40 hours a week, but some employers define full-time work differently or have times of the year where employees work fewer hours, like “Summer Fridays,” then you need to adjust your productivity expectations accordingly.

Calculating the difference between 35 hours a week instead of 40 hours across a dozen coders results in a lot of hours, Speroni notes.

Balancing employee perks like summer Fridays versus timely coding practices may mean adjusting your hiring, if your practice can swing the budget to make up those hours with additional personnel.

Now that you know what factors you should consider, you need numbers. Performing productivity reports or an audit with a larger scope can provide the data you need to dial in on exactly what is working — or not working — with your provider and support personnel ratios.